| Abdomen 2 views (74019) |
$126.50 |
$230 |
1.2× |
| Acute gastrointestinal blood loss imaging (78278) |
$531.85 |
$967 |
1.3× |
| Angiography extremity bilateral rs&i (75716) |
$3,330.80 |
$6,056 |
1.1× |
| Angiography extremity unilateral rs&i (75710) |
$3,512.30 |
$6,386 |
1.1× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$2,962.85 |
$5,387 |
0.5× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$2,962.85 |
$5,387 |
0.9× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,352.45 |
$2,459 |
0.4× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$6,040.10 |
$10,982 |
1.1× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$332.20 |
$604 |
0.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,352.45 |
$2,459 |
0.4× |
| Ankle 2 views (73600) |
$102.85 |
$187 |
1.2× |
| Antegrade urography radiological supvj & interpj (74425) |
$352 |
$640 |
1.0× |
| Aortogram thoracic (75605) |
$2,962.85 |
$5,387 |
0.5× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,998.60 |
$5,452 |
0.9× |
| Aortography abdominal serialography rs&i (75625) |
$3,012.90 |
$5,478 |
1.0× |
| Arthrogram elbow (73085) |
$525.80 |
$956 |
1.5× |
| Arthrogram hip (73525) |
$525.80 |
$956 |
1.5× |
| Arthrogram shoulder (73040) |
$525.80 |
$956 |
1.5× |
| Arthrogram wrist (73115) |
$525.80 |
$956 |
1.5× |
| Arthrography knee lt (73580) |
$525.80 |
$956 |
1.5× |
| Bone &/Joint Imaging Limited Area (78300) |
$570.35 |
$1,037 |
1.4× |
| Bone &/joint imaging whole body (78306) |
$570.35 |
$1,037 |
1.4× |
| Bone age studies (77072) |
$178.20 |
$324 |
1.7× |
| Bone Imaging 3 Phase (78315) |
$570.35 |
$1,037 |
1.4× |
| Bone survey complete (77075) |
$138.05 |
$251 |
1.3× |
| Brain Imaging Vascular Flow Only (78610) |
$675.40 |
$1,228 |
1.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$494.45 |
$899 |
1.4× |
| Cervical spine 2 or 3 views (72040) |
$102.85 |
$187 |
1.2× |
| Chest 1 view (71045) |
$102.85 |
$187 |
1.2× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$207.90 |
$378 |
1.2× |
| Clavicle complete (73000) |
$102.85 |
$187 |
1.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$126.50 |
$230 |
1.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$703.45 |
$1,279 |
2.0× |
| CT abdomen and pelvis without contrast (74176) |
$449.35 |
$817 |
1.9× |
| CT abdomen w contrast (74160) |
$592.90 |
$1,078 |
3.4× |
| CT abdomen w wo contrast (74170) |
$703.45 |
$1,279 |
4.0× |
| CT abdomen w/o contrast (74150) |
$449.35 |
$817 |
4.3× |
| CT angio hrt w/3d image (75574) |
$277.75 |
$505 |
0.8× |
| CT angiography upper extremity lt (73206) |
$705.65 |
$1,283 |
4.0× |
| CT c-spine w/o contrast (72125) |
$449.35 |
$817 |
4.3× |
| CT cere prfuj alys c+ w/o CT/CTA same anatomy (70473) |
$295.90 |
$538 |
1.7× |
| CT cervical spine w&w/o contrast (72127) |
$261.25 |
$475 |
1.5× |
| CT cervical spine with contrast (72126) |
$592.90 |
$1,078 |
1.7× |
| CT chest w/wo contrast (71270) |
$703.45 |
$1,279 |
4.0× |
| CT chest with contrast (71260) |
$592.90 |
$1,078 |
3.4× |
| CT head/brain with contrast (70460) |
$592.90 |
$1,078 |
3.4× |
| CT head/brain without and with contrast (70470) |
$703.45 |
$1,279 |
4.0× |
| CT heart no contrast quant eval coronry calcium (75571) |
$27.50 |
$50 |
0.3× |
| CT iac w contrast (70481) |
$592.90 |
$1,078 |
3.4× |
| CT limited/localized follow up study (76380) |
$220.55 |
$401 |
2.5× |
| CT lower ext w/o (73700) |
$449.35 |
$817 |
4.3× |
| CT lower extremity w wo contrast (73702) |
$703.45 |
$1,279 |
4.0× |
| CT lower extremity with contrast (73701) |
$592.90 |
$1,078 |
3.4× |
| CT lumbar spine w & w/o contrast (72133) |
$703.45 |
$1,279 |
4.0× |
| CT lumbar spine w/o contrast (72131) |
$449.35 |
$817 |
4.3× |
| CT lumbar spine with contrast (72132) |
$592.90 |
$1,078 |
1.7× |
| CT maxillofacial w contrast (70487) |
$592.90 |
$1,078 |
3.4× |
| CT maxillofacial w/o contrast (70486) |
$449.35 |
$817 |
4.3× |
| CT maxillofacial w/wo contrast (70488) |
$703.45 |
$1,279 |
4.0× |
| CT neck soft tissue w contrast (70491) |
$592.90 |
$1,078 |
3.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$703.45 |
$1,279 |
4.0× |
| CT orbits w/o contrast (70480) |
$449.35 |
$817 |
4.3× |
| CT pelvis w/o contrast (72192) |
$449.35 |
$817 |
4.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$705.65 |
$1,283 |
4.0× |
| CT soft tissue neck w/o contrast (70490) |
$449.35 |
$817 |
4.3× |
| CT thoracic spine w/contrast (72129) |
$592.90 |
$1,078 |
3.4× |
| CT thoracic spine w/o contrast (72128) |
$449.35 |
$817 |
4.3× |
| CT thoracic spine w/wo contrast (72130) |
$703.45 |
$1,279 |
4.0× |
| CT thorax w/o contrast (71250) |
$287.92 |
$523.50 |
2.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$703.45 |
$1,279 |
4.0× |
| CT upper extremity w/o contrast rt (73200) |
$449.35 |
$817 |
4.3× |
| CT upper extremity with contrast (73201) |
$592.90 |
$1,078 |
1.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$705.65 |
$1,283 |
4.0× |
| Cta Abdomen (74175) |
$591.25 |
$1,075 |
3.4× |
| CTA abdomen pelvis (74174) |
$592.08 |
$1,076.50 |
1.7× |
| CTA chest (71275) |
$703.45 |
$1,279 |
4.0× |
| Cta Head (70496) |
$705.65 |
$1,283 |
4.0× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$590.15 |
$1,073 |
1.7× |
| CTA lwr ext w&w/o contrast (73706) |
$705.65 |
$1,283 |
4.0× |
| Cta Neck (70498) |
$705.65 |
$1,283 |
4.0× |
| Cta Pelvis (72191) |
$591.25 |
$1,075 |
3.4× |
| Cystography minimum 3 views rs&i (74430) |
$352 |
$640 |
1.0× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$232.65 |
$423 |
2.2× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$345.40 |
$628 |
3.3× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$143 |
$260 |
1.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$169.95 |
$309 |
1.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$154.55 |
$281 |
1.8× |
| Echo exam of fetal heart (76825) |
$612.15 |
$1,113 |
1.1× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$229.35 |
$417 |
1.0× |
| Esophagus (74220) |
$207.90 |
$378 |
1.2× |
| Fetal biophysical profile non-stress testing (76818) |
$118.80 |
$216 |
1.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$126.50 |
$230 |
1.2× |
| Fluoroscopy up to 1 hr (76000) |
$184.25 |
$335 |
0.8× |
| Foot 2 views (73620) |
$154 |
$280 |
1.8× |
| Forearm 2 views (73090) |
$102.85 |
$187 |
1.2× |
| Gated Heart Planar Single (78472) |
$600.60 |
$1,092 |
1.5× |
| Hand 2 views (73120) |
$102.85 |
$187 |
1.0× |
| Hand 3 views (73130) |
$102.85 |
$187 |
1.2× |
| Heart Infarct Image (78466) |
$600.05 |
$1,091 |
1.5× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$271.15 |
$493 |
0.5× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$271.15 |
$493 |
0.7× |
| Ht muscle image spect sing (78451) |
$1,733.60 |
$3,152 |
1.3× |
| Humerus Min 2 Views Left (73060) |
$102.85 |
$187 |
1.2× |
| Hysterosalpingogram (74740) |
$430.10 |
$782 |
1.8× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$497.75 |
$905 |
0.9× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$587.40 |
$1,068 |
1.1× |
| Knee 3 views (73562) |
$102.85 |
$187 |
1.2× |
| Liver & spleen imaging static only (78215) |
$636.90 |
$1,158 |
1.6× |
| Lung perf&ventilat diferentl (78598) |
$292.05 |
$531 |
0.5× |
| Lung perfusion differential (78597) |
$187 |
$340 |
0.5× |
| Lymphoscintigraphy (78195) |
$568.15 |
$1,033 |
1.0× |
| Mammary ductogram or galactogram multiple (77054) |
$229.35 |
$417 |
1.0× |
| Meckels Diverticulum (78290) |
$531.85 |
$967 |
1.3× |
| MRA head w & w/o contrast (70546) |
$1,179.75 |
$2,145 |
3.4× |
| MRA head w/o contrast (70544) |
$825.55 |
$1,501 |
3.5× |
| MRA head with contrast (70545) |
$891.55 |
$1,621 |
2.6× |
| MRA neck w contrast (70548) |
$891.55 |
$1,621 |
2.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,179.75 |
$2,145 |
3.4× |
| MRA neck w/o contrast (70547) |
$825.55 |
$1,501 |
3.5× |
| MRI abdomen w contrast (74182) |
$891.55 |
$1,621 |
2.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,179.75 |
$2,145 |
3.4× |
| MRI abdomen w/o contrast (74181) |
$825.55 |
$1,501 |
3.5× |
| MRI any jnt lwr ext with con lt (73722) |
$891.55 |
$1,621 |
1.1× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$891.55 |
$1,621 |
1.1× |
| MRI breast w/o contrast bilateral (77047) |
$825.55 |
$1,501 |
3.5× |
| MRI breast w/o contrast unilat (77046) |
$825.55 |
$1,501 |
3.5× |
| MRI c-spine with contrast (72142) |
$891.55 |
$1,621 |
2.6× |
| MRI cardiac w/o contrast (75557) |
$308.55 |
$561 |
1.3× |
| MRI cervical spine w/o contrast (72141) |
$825.55 |
$1,501 |
3.5× |
| MRI chest w/o & w/contrast material (71552) |
$1,179.75 |
$2,145 |
3.4× |
| MRI chest w/o contrast (71550) |
$914.10 |
$1,662 |
3.8× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$891.55 |
$1,621 |
2.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$891.55 |
$1,621 |
2.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$825.55 |
$1,501 |
3.5× |
| MRI orbit face &/neck w/o contrast (70540) |
$825.55 |
$1,501 |
3.5× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,179.75 |
$2,145 |
3.4× |
| MRI orbit/face/neck w/contrast (70542) |
$1,035.38 |
$1,882.50 |
3.0× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,179.75 |
$2,145 |
3.4× |
| MRI pelvis w/o contrast (72195) |
$825.55 |
$1,501 |
3.5× |
| MRI scan of arm joint before and after contrast (73223) |
$1,179.75 |
$2,145 |
3.4× |
| MRI scan of leg joint before and after contrast (73723) |
$1,179.75 |
$2,145 |
3.4× |
| MRI spectroscopy (76390) |
$595.10 |
$1,082 |
6.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,179.75 |
$2,145 |
3.4× |
| MRI spinal canal lumbar w/contrast material (72149) |
$891.55 |
$1,621 |
2.6× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,179.75 |
$2,145 |
3.4× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$891.55 |
$1,621 |
2.6× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,179.75 |
$2,145 |
3.4× |
| MRI thoracic spine w/o contrast (72146) |
$825.55 |
$1,501 |
3.5× |
| MRI tmj (70336) |
$661.65 |
$1,203 |
2.8× |
| MRI upper ext joint w/o contrast (73221) |
$825.55 |
$1,501 |
3.5× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,179.75 |
$2,145 |
3.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$825.55 |
$1,501 |
3.5× |
| Myelogram Cervical (72240) |
$363.55 |
$661 |
0.5× |
| Myelogram Lumbar (72265) |
$363.55 |
$661 |
0.5× |
| Myelogram thoracic (72255) |
$363.55 |
$661 |
0.5× |
| Myelography 2 or more regions (72270) |
$363.55 |
$661 |
0.5× |
| Myocardial Spect Multiple Studies (78452) |
$1,456.95 |
$2,649 |
1.1× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$665.50 |
$1,210 |
0.8× |
| Neck soft tissue (70360) |
$102.85 |
$187 |
1.2× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$315.15 |
$573 |
0.8× |
| Nm bone marrow multiple (78103) |
$568.15 |
$1,033 |
1.4× |
| Nm cisternogram (78630) |
$653.40 |
$1,188 |
1.2× |
| Nm gastric emptying study (78264) |
$531.85 |
$967 |
1.3× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$866.80 |
$1,576 |
0.7× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$866.80 |
$1,576 |
0.7× |
| Nuclear Rx Oral Admin (79005) |
$467.22 |
$849.50 |
2.0× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$149.60 |
$272 |
1.4× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$108.97 |
$198.12 |
1.0× |
| Orthopantogram (70355) |
$104.50 |
$190 |
1.2× |
| Osseous survey infant (77076) |
$124.85 |
$227 |
1.2× |
| Parathyroid imaging (78070) |
$394.90 |
$718 |
1.0× |
| Pelvis 1 or 2 views (72170) |
$126.50 |
$230 |
1.2× |
| PET image w/CT, skull-thigh (78815) |
$3,203.20 |
$5,824 |
2.2× |
| PET imaging CT for attenuation limited area (78814) |
$2,301.75 |
$4,185 |
1.6× |
| PET imaging for CT attenuation whole body (78816) |
$3,203.20 |
$5,824 |
2.2× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,179.75 |
$2,145 |
3.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$462.55 |
$841 |
1.2× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$292.05 |
$531 |
0.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$612.15 |
$1,113 |
1.1× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$73.70 |
$134 |
0.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$122.10 |
$222 |
1.2× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$102.85 |
$187 |
1.0× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$140.80 |
$256 |
1.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$102.85 |
$187 |
1.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$102.85 |
$187 |
1.2× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$102.85 |
$187 |
1.2× |
| Radiologic exam colon single contrast study (74270) |
$207.90 |
$378 |
1.2× |
| Radiologic exam teeth prtl exam < full mouth (70310) |
$48.95 |
$89 |
0.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$207.90 |
$378 |
1.2× |
| Radiologic exam upr gi trc single contrast study (74240) |
$207.90 |
$378 |
1.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$98.45 |
$179 |
1.1× |
| Radiological examination surgical specimen (76098) |
$612.15 |
$1,113 |
1.1× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$3,698.75 |
$6,725 |
1.2× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$579.70 |
$1,054 |
1.1× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,456.95 |
$2,649 |
2.7× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,734.15 |
$3,153 |
1.3× |
| Rp Therapy Intravenous Administration (79101) |
$304.15 |
$553 |
1.3× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$402.05 |
$731 |
1.7× |
| Scanogram (77073) |
$118.80 |
$216 |
1.1× |
| Scapula complete (73010) |
$102.85 |
$187 |
1.0× |
| Screening digital breast tomosynthesis (77063) |
$66 |
$120 |
2.8× |
| Sella turcica (70240) |
$102.85 |
$187 |
1.2× |
| Small bowel series (74250) |
$207.90 |
$378 |
1.2× |
| Spine thoracic 3 views (72072) |
$126.50 |
$230 |
1.2× |
| Thyroid carcinoma metastases img whole body (78018) |
$580.25 |
$1,055 |
1.1× |
| Thyroid Imaging With Vascular Flow (78013) |
$183.70 |
$334 |
0.5× |
| Thyroid uptake measurement (78012) |
$139.70 |
$254 |
0.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$448.80 |
$816 |
1.1× |
| Tmj unilateral (70328) |
$102.85 |
$187 |
1.2× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$579.70 |
$1,054 |
1.1× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$580.25 |
$1,055 |
1.4× |
| Ultrasound scan of cornea to determine thickness (76514) |
$56.03 |
$101.88 |
1.9× |
| Ultrasound scan to determine eye length and lens power (76519) |
$112.28 |
$204.15 |
1.1× |
| Ultrasound, abdomen limited (76705) |
$144.65 |
$263 |
1.4× |
| Umbilical-artery Doppler (OB) (76820) |
$243.65 |
$443 |
2.3× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$29.15 |
$53 |
0.3× |
| Unlisted Ultrasound Procedure (76999) |
$106.15 |
$193 |
1.2× |
| Upper Extremity Infant (73092) |
$169.40 |
$308 |
1.6× |
| Urethrocystography retrograde rs&i (74450) |
$352 |
$640 |
1.5× |
| Urethrocystography voiding (74455) |
$352 |
$640 |
1.5× |
| Us abdl aorta screen aaa (76706) |
$144.65 |
$263 |
1.4× |
| Us breast unilateral complete (76641) |
$149.60 |
$272 |
1.4× |
| Us breast unilateral limited (76642) |
$152.90 |
$278 |
1.8× |
| Us chest (76604) |
$144.65 |
$263 |
1.4× |
| Us compl joint r-t w/image documentation (76881) |
$245.44 |
$446.25 |
2.3× |
| Us fetal nuchal translucency 1st gestation (76813) |
$92.40 |
$168 |
0.9× |
| Us guided compression repair (76936) |
$298.65 |
$543 |
1.4× |
| Us kidney transplant (76776) |
$135.30 |
$246 |
1.3× |
| Us ob detailed single fetus (76811) |
$402.05 |
$731 |
1.7× |
| Us ob transvaginal (76817) |
$149.60 |
$272 |
1.4× |
| Us pelvic non ob complete (76856) |
$255.20 |
$464 |
2.4× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$144.65 |
$263 |
1.4× |
| Us pregnancy ltd (76815) |
$149.60 |
$272 |
1.4× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$239.25 |
$435 |
2.3× |
| Us retroperitoneal complete (76770) |
$227.15 |
$413 |
2.2× |
| Us retroperitoneal limited (76775) |
$144.65 |
$263 |
1.4× |
| Us scrotum and contents (76870) |
$227.15 |
$413 |
2.2× |
| Us soft tissue head/neck (76536) |
$227.15 |
$413 |
2.2× |
| Us spinal canal and contents (76800) |
$227.15 |
$413 |
2.2× |
| Us transrectal (76872) |
$227.15 |
$413 |
2.2× |
| Us xtr non-vasc lmtd (76882) |
$144.65 |
$263 |
1.4× |
| Us, eye b-scan (76512) |
$117.15 |
$213 |
1.1× |
| Venogram extremity bilateral (75822) |
$1,733.60 |
$3,152 |
1.1× |
| Venography caval inferior serialography rs&i (75825) |
$3,512.30 |
$6,386 |
1.1× |
| Venography caval superior serialography rs&i (75827) |
$1,352.45 |
$2,459 |
0.9× |
| Venography extremity unilateral rs&i (75820) |
$1,733.60 |
$3,152 |
1.1× |
| Wrist 2 views (73100) |
$102.85 |
$187 |
1.2× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$178.20 |
$324 |
1.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$102.85 |
$187 |
1.2× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$102.85 |
$187 |
1.2× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$321.75 |
$585 |
1.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$102.85 |
$187 |
1.2× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$102.85 |
$187 |
1.2× |
| X-ray exam entire spi 4/5 vw (72083) |
$139.15 |
$253 |
1.3× |
| X-ray exam hip uni 1 view (73501) |
$74.25 |
$135 |
0.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$90.75 |
$165 |
1.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$122.65 |
$223 |
1.2× |
| X-ray exam of femur 1 (73551) |
$74.25 |
$135 |
0.9× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$102.85 |
$187 |
1.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$102.85 |
$187 |
1.2× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$154 |
$280 |
1.8× |
| X-ray head for orthodontia (70350) |
$98.45 |
$179 |
1.1× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$102.85 |
$187 |
1.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$102.85 |
$187 |
1.2× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$118.80 |
$216 |
1.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$102.85 |
$187 |
1.2× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$139.15 |
$253 |
1.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$126.50 |
$230 |
1.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$161.42 |
$293.50 |
1.5× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$178.20 |
$324 |
1.7× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$102.85 |
$187 |
1.2× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$102.85 |
$187 |
1.0× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$102.85 |
$187 |
1.0× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$246.40 |
$448 |
0.5× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$352 |
$640 |
1.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$102.85 |
$187 |
1.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$178.20 |
$324 |
1.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$102.85 |
$187 |
1.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$102.85 |
$187 |
1.2× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$102.85 |
$187 |
1.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$102.85 |
$187 |
1.2× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$102.85 |
$187 |
1.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$178.20 |
$324 |
1.7× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$102.85 |
$187 |
1.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$102.85 |
$187 |
1.2× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$102.85 |
$187 |
1.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$102.85 |
$187 |
1.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$102.85 |
$187 |
1.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$497.20 |
$904 |
5.7× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$102.85 |
$187 |
1.2× |
| Xr arthrogram ankle (73615) |
$525.80 |
$956 |
1.5× |
| Xr c-spine 6 or more views (72052) |
$178.20 |
$324 |
1.7× |
| Xr finger(s) 2+ views (73140) |
$102.85 |
$187 |
1.2× |
| XR Mastoids < 3 Views Bilateral (70120) |
$102.85 |
$187 |
1.0× |
| Xr shoulder 1 view (73020) |
$102.85 |
$187 |
1.2× |
| Xr spine cervical 4 or 5 views (72050) |
$178.20 |
$324 |
1.7× |
| Xr tibia/fibula 2 views (73590) |
$102.85 |
$187 |
1.2× |
| Xr tmj bilateral (70330) |
$102.85 |
$187 |
1.2× |
| Xray knee 1 or 2 views rt (73560) |
$102.85 |
$187 |
1.2× |